Healthcare Provider Details

I. General information

NPI: 1952426892
Provider Name (Legal Business Name): ANNIE CROWDER RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS ANNIE LEWIS

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 05/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8630 FENTON ST STE 1204
SILVER SPRING MD
20910-3808
US

IV. Provider business mailing address

5408 DUKE DR
FAIRVIEW HEIGHTS IL
62208-3904
US

V. Phone/Fax

Practice location:
  • Phone: 301-340-7525
  • Fax: 301-495-0318
Mailing address:
  • Phone: 314-814-8670
  • Fax: 314-814-8542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAC002288
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: